Warning bellsThe concerned must plan now for further shocks—the worst of the crisis is yet to come.
There is still much that is unknown of the novel coronavirus. Let alone reports that it causes previously undocumented chronic complications to internal organs like kidneys, other than the deadly respiratory disease Covid-19, new warnings from the World Health Organisation that the disease may become endemic, like HIV (except much more easily infectious), have suddenly extended the timeline to when life can return to a semblance of normalcy. Experts’ predictions of the world accepting a new normal seem to be proving truer. What is fact, however, is that lack of preparedness will make the body count much higher.
It was back in early March when The Guardian sounded a severe warning, coming from health experts, on the United States’ lack of preparedness and capacity—especially in rural areas and because of the lack of coordination—saying the situation would overwhelm the country. Here, we are talking about one of the most powerful and wealthy countries in the world. A mere two months later, the US has over 1.3 million confirmed cases and over 84,000 deaths; less than 245,000 have recovered.
If the exponential increase has occurred in countries like the US, Italy, the UK, India and China, among many others, there are no indications that it will miraculously not happen in Nepal. There is no magic immunity—Nepalis have died in other countries, due to this virus. Yet, despite multiple warnings from the Post, besides others in the media, the government has failed to scale up the healthcare capacity nationwide. It has failed to isolate, contain and trace the spread of SARS-CoV-2, essentially reversing weeks of development in staggering the increase in positive cases. Worse, it has even let slide previous gains in immunisation, neonatal and antenatal care, and other health facilities available to the public during normal times.
Now, in an alarming report, UNICEF has claimed that an additional 670 children, on average, could lose their lives every month in Nepal, should things remain as they are. The report’s estimates come from research published in The Lancet which attempts to estimate the indirect effects of Covid-19, from ‘the potential disruption of health systems and decreased access to food’, on maternal and child health.
Already over the past few months, the signs have tended to point to this fact. The significant strides that Nepal had made in combating maternal mortality had already begun to slip. Even as the media exposed the ridiculous oversubscription of unnecessary vehicle passes, expectant mothers have been unable to visit healthcare facilities for crucial antenatal checkups that usually catch complications in time to save mothers and babies. Similarly, many patients with other complications, especially outside metropolitan areas, have been unable to reach healthcare facilities due to lower access to transportation during the lockdown.
On the immunisation front, too, there have been major slippages. An area previously announced as a measles-free zone became the centre of a new outbreak of the disease so deadly to children. The stock of vaccines that protect against critical childhood diseases such as polio is also diminishing, as global supply disruptions have threatened their availability in Nepal. Further, and tipping the scales precariously, many migrant workers are expected to lose their jobs amidst an uncertain global economy; they are expected to come home to an economy that already had almost a million unemployed. This situation is sure to put pressure on livelihood sustainability—severely hampering children.
The concerned agencies in Nepal should treat this as the canary in the coal mine. When the impending crisis hits full-scale, the government cannot be afforded the benefit of the doubt, when it clearly has received plenty of warnings. The federal government must coordinate with provincial and local authorities to implement a comprehensive strategy. Food, medication, healthcare capacity must all be appraised—it must plan for further supply disruptions. The most vulnerable must be locally identified, and the upcoming budget must plan fiscal activities to mitigate the effect in critical regions.